As the current administration and New Jersey legislative session wind down, there is still opportunity to create meaningful change for our state’s children. For too long, children’s oral health has been overlooked, even though good dental care is vital to overall health, development, and well-being.

Untreated dental problems are a leading cause of school absences and can hinder academic and social growth. Oral health is the literal entry point for overall good health. Unfortunately, the New Jersey Department of Health’s Basic Screening Survey found that 36% of third graders have untreated tooth decay, nearly twice the national average.

One reason that New Jersey struggles with providing good oral health is access challenges for children enrolled in New Jersey Medicaid. Many dentists do not participate in New Jersey Medicaid because the rates they are paid are very low.  The fee-for-service rates that the State pays have not changed since 2007 — and the five Medicaid Managed Care Organizations (MCOs) generally pay less than those rates. In fact, a comparison of New Jersey Medicaid’s reimbursement rates for children’s dental care with data collected by the American Dental Association shows that New Jersey rates are in the bottom 10% of the nation.

Lawmakers and Governor Murphy can address this issue and help New Jersey’s children by enacting the Healthy Smiles Act (S4298/A5471). The Healthy Smiles Act calls for a 20 percent increase in fee-for-service reimbursement rates and requires MCOs to pay at least those rates. It also includes a cost-of-living adjustment so that the rates will not remain frozen for another 19 years. You or your organization can join our call for passage of the Act by signing onto our support letter here.

Last year, the Quality Institute conducted a secret shopper survey of all 824 of the general and pediatric dental practices in the five MCO network directories of dentists serving children aged 0 to 6. Our goal was to quantify the extent of the access challenges. We found that just 49 percent of practices would schedule an appointment for a two-year-old child. All dental and medical societies and experts recommend that children begin to see a dentist by age one or when teeth have come in. Also, 37 percent of the practices reported that they do not participate in the network even though they were listed in the directory. These ghost networks harm New Jersey families.

The State can start to fix the problem by passing the Healthy Smiles Act and righting the wrongs of woefully low payments for dental care. In addition, New Jersey Medicaid and the New Jersey Department of Banking and Insurance must actively enforce the network adequacy rules and the requirements in the MCO contract to ensure accountability and patient access.

The Quality Institute is working closely with many organizations on this issue, including the New Jersey Dental Association, KinderSmile Foundation, and the New Jersey Oral Health Coalition. These groups, and many others, have joined our call for passage of the Healthy Smiles Act. Please help us keep our state’s children smiling and help address avoidable tooth loss, decay, pain, and life-threatening conditions by improving regular access to preventive oral health.